Multiple sclerosis (MS) is a debilitating chronic inflammatory demyelinating disease that affects the central nervous system. The underlying cause of multiple sclerosis is unknown, yet there are various predisposing factors. Currently, bariatric surgery is an increasingly common solution for obesity. It has been reported that bariatric procedures result in miscellaneous neurological complications. To the best of our knowledge, this is the first case series to report the occurrence of MS following bariatric surgery. Here we report the cases of five patients who were recruited for inclusion following neurological examination, complete cerebrospinal fluid (CSF) study, enhanced cranial as well as spinal cord magnetic resonance (MR) images. Diagnosis of multiple sclerosis was made based on McDonalds criteria (2010). All cases were diagnosed with relapsing-remitting form of multiple sclerosis (RRMS) after various types of bariatric surgeries.

Context: Medication nonadherence is a significant barrier in achieving seizure freedom in patients with epilepsy. There is a deficiency of data about the reasons for nonadherence in Saudi population. Aims: The aim of this study is to prove the existence of nonadherence to antiepileptic drugs (AEDs) in patients with epilepsy and identify the responsible factors. Setting and Design: This is a prospective, cross-sectional study carried in the Department of Neurology at King Fahd Hospital of the University affiliated with Imam Abdulrahman Bin Faisal University. Subjects and Methods: Patients of all ages diagnosed to have epilepsy as mentioned in their medical record and taking antiepileptic medications were interviewed using a questionnaire. Statistical Analysis Used: Statistical analysis was performed using IBM Statistical Package for the Social Sciences version 21 (IBM Corp., Armonk, NY, USA). Statistical significance was defined as two-tailed with a P ≤ 0.05. Results: Among 152 participants, 52.6% were male and 47.4% were female. Mean age of the patients was 28 ± 14.3 (mean ± standard deviation) years. Of 152 patients, 48.7% were found to be nonadherent to their AED therapy. The most commonly identified factor was forgetfulness. Nonadherence was significantly associated with poor seizure control (P = 0.002). Conclusion: Nonadherence to the AED is common among patients with epilepsy and affects seizure control adversely.

Objective: Our study aims to evaluate the etiologic and clinical features of cerebral venous sinus thrombosis (CVST) in Saudi Arabia, and secondarily whether gender plays a role in CVST. Materials and Methods: Data were collected retrospectively from the stroke registry during the period from January 2008 to April 2018, and the patients with the diagnosis of CVST were identified, and data were analyzed for any gender-specific differences in clinical presentation and etiology of cerebral venous thrombosis. Results: There were 15 females while 11 males with a female:male ratio of 1.4:1. The mean age was 29.4± standard deviation 8.9 with the age range of 15–49. Headache was the most common and usually the first presenting symptoms present in 65% followed by hemiparesis and cranial nerve palsies. The first neurological examination was normal in 9/26 (34.6%) of the patients, while the common abnormality was cranial nerve palsies. Infections and trauma played an important part in risk factor analysis of our patient after the pregnancy- and hormone-related conditions. Some significant differences between the clinical presentation and risk factors among males and females were noted as age at presentation was higher in females while trauma and infections were common in male patients, although the involvement of the sinuses and response to treatment did not prove to be statistically significant. Conclusion: The results of this study were similar to the available literature with few differences. The relatively higher proportion of males in our study can be explained partly with more cases of traumatic CVST. Some important differences were noted between the risk factors and clinical presentation among genders. Large-scale prospective studies are needed to further clarify these differences.

2019 has been an excellent year in terms of peptides and oligonucleotides (TIDES) approved by the FDA. Despite the drop in the number of total drugs approved by the FDA in 2019 in comparison with 2018 (48 vs. 59), the total number of TIDES authorized increased (seven vs. three). Year after year, TIDES are increasingly present in therapy, as imaging agents, theragnostic and constituent moieties of other complex drugs, such as antibody drug conjugates. This means a consolidation of these kinds of drugs in the pharmaceutical arena, paving the way in the coming years for the approval of others for diverse medical indications. Here the TIDES approved in 2019 are analyzed in terms of chemical structure, medical target, mode of action, and adverse effects.

Background: The most effective treatment for severe acne is isotretinoin. However, it carries major side effects, such as teratogenicity, depression, and increased lipid profiles. It is advised to monitor the lipid profile and to use two forms of contraception during isotretinoin use. Although it is commonly prescribed, little data are available regarding patients' understanding of isotretinoin. Objectives: The aim of this study is to assess Saudi female college students' knowledge about isotretinoin use and side effects. Methods: Data were collected by a validated online questionnaire disseminated through social media, allowing the collection of information from students from different regions of the country. Results: The total number of responses was 622. The majority of respondents were 18–24 years old, single, and college students; all were female. About 48.6% (282) of the sample used isotretinoin. Most had good knowledge of isotretinoin side effects. Medical students were more knowledgeable than students of other majors, and users were more knowledgeable than nonusers. The most common side effect was dryness. Use among married females was 2.8%, the majority of whom were instructed by their physicians to use only one method of contraception. One respondent got pregnant while using the drug. Conclusion: College-aged females generally have good knowledge of isotretinoin and its side effects. However, awareness about proper contraceptive use while on the drug is lacking.

Objectives: This study aimed to determine the relationship between glycaemic control and carotid atherosclerotic disease among patients with acute ischaemic stroke (AIS). Methods: This retrospective cross-sectional study took place in the Neurology Department of King Fahad Hospital of University, Khobar, Saudi Arabia, from April to October 2017. Data were collected from the medical records of 244 patients with a diagnosis of AIS confirmed by computed tomography. Doppler ultrasounds of the carotid artery were performed to determine the presence of increased carotid intima media thickness (CIMT) and plaques. Results: Significantly higher mean glycated haemoglobin (HbA1c) levels were noted in cases with high CIMT values (P = 0.002), but not in cases with carotid plaques (P = 0.360). In addition, there was a significant association between diabetes mellitus (DM) and high CIMT (P = 0.045), but not with carotid plaques (P = 0.075). Finally, while dyslipidaemia and age were independently correlated with high CIMT values (P = 0.034 and 0.050 each). Conclusion: High HbA1c levels were associated with high CIMT values, but not with carotid plaques. Therefore, HbA1c levels may be useful as an indirect marker of the initial stages of carotid artery atherosclerosis. Keywords: Glycated Hemoglobin A1c; Diabetes Mellitus; Carotid Intima-Media Thickness; Atherosclerotic Plaque; Stroke.

STEM education in the United States is often described as being in a downward spiral, when assessed by competency test scores and lack of student motivation for engaging STEM disciplines. The authors suggest this arises from an overly instrumental view of STEM. While STEAM has arisen as a pushback paradigm, the application of STEAM in schools is challenging, and educators are often unclear about connecting STEM and the arts. The authors suggest envisioning STEAM through natural disciplinary interconnections. They focus on the integration of language arts and figurative thinking to blur the boundaries of STEM and the arts, and offer examples of figurative language—such as metaphor, linguistic etymology and synecdoche—for framing STEM teaching and learning. [ABSTRACT FROM AUTHOR]

Design thinking has been receiving increased scholarly and popular interest in education; yet, teachers are often uncertain about what it means to implement this in their educational settings. Design thinking, nonetheless, offers a framework to address the challenging problems of practice educators face. In this article, we examine a graduate-level teacher education course, at a Midwestern US university, which uses the Stanford Design Thinking Model. Educators in the course found that exposure to and practice of the design thinking model allowed them to creatively solve problems of practice relevant to their context. In particular, educators reported three main takeaways from the experience: (1) valuing empathy, (2) becoming open to uncertainty, and (3) seeing teaching as design. We discuss implications and challenges for scholarship and practice. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the combined effect of mechanical surface treatment with intermediate bonding agents (methyl methacrylate [MMA] and silane coupling agents) and ZrO2 nanoparticle (nano‐ZrO2) addition to repair material on the shear bond strength (SBS) of repaired denture bases. Materials and Methods: Heat‐polymerized acrylic resin was used to fabricate 130 cylindrical blocks (15 mm × 10 mm) and divided into a control group without treatment (C, n = 10), and 3 repair groups (n = 40/group) divided into specimens treated with alumina blasting alone (AB), specimens blasted with alumina combined with silane coupling agent (AB + SCA), or combined with MMA‐based composite bonding agent (AB + MA). Treated groups were further subdivided according to nano‐ZrO2 concentrations into 0 wt%, 2.5 wt%, 5 wt%, and 7.5 wt% added to repair resin powder. Repair resin monomer and polymer were combined and packed on the repair area and then placed in a pressure pot at 37°C for 15 minutes for polymerization. Shear bond test was performed using a universal testing machine. Scanning electron microscopy (SEM) was used to examine the effect of surface modifications on repair surfaces and to evaluate the topography of fracture surfaces. Tukey‐Kramer multiple‐comparison test was used to detect significant differences between groups (p ≤ 0.05). Results: SBS (MPa) of specimens treated with alumina blasting and application of intermediate agents were significantly higher than the control group (p < 0.05), while no significant differences were found between AB and control group (p > 0.05). Nano‐ZrO2 addition significantly increased SBS except for AB, and 5%, 7.5% MA (p > 0.05). SEM evaluation showed that alumina blasting created rougher and more porous surfaces, while SCA and MA reduced the irregularities and fissures. Conclusion: Application of bonding agents to repair surfaces after alumina blasting improved the repair bond strength and proved to be a possible new adhesive method for denture repair. Moreover, nano‐ZrO2 addition in combination with surface treatment improved the repair bond strength. [ABSTRACT FROM AUTHOR]

In 2018, the United States Food and Drug Administration (FDA) approved a total of 59 new drugs, three of them (5%) are TIDES (or also, -tides), two oligonucleotides and one peptide. Herein, the three TIDES approved are analyzed in terms of medical target, mode of action, chemical structure, and economics.

BACKGROUND: Drug shortages are a serious and complex issue in any healthcare system. We conducted this study because the prevalence of drug shortages in Saudi Arabia is largely unknown, while there have been reports of shortages. OBJECTIVE: To explore the prevalence and characteristics of drug shortages as well as identify strategies to minimize their impact on patient care and safety in large hospitals. DESIGN: Questionnaire-based cross-sectional study. SETTING: Pharmacy departments in secondary and tertiary care hospitals in the city of Riyadh. SUBJECTS AND METHODS: Pharmacists in ten hospitals, categorized as Ministry of Health [MOH], MOH-affiliated medical cities, and non-MOH, were recruited using convenience sampling. The European Association of Hospital Pharmacists drug shortage questionnaire was administered to survey pharmacists about drug shortages in their hospitals. MAIN OUTCOME MEASURES: Percentages of drug class shortages, characteristics, and strategies to minimize impact on patient care and safety across each hospital sector. RESULTS: Of 200 pharmacists invited to participate, 120 pharmacists completed the questionnaire (60% response rate). Twenty-four percent were from MOH hospitals, 32% from MOH-affiliated medical cities, and 44% from non-MOH hospitals. A significantly higher percentage of pharmacists from MOH-affiliated medical cities (42.11%) reported encountering drug shortages on a daily basis compared to 13.79% and 15.09% of participants from MOH-hospitals and non-MOH hospitals, respectively (P=.001). The top three drug classes that ≥ 25% of participants reported having shortages of were cardiovascular, antineoplastic, and endocrine drugs. The two most common strategies that were reported to minimize the impact of drug shortages on patient care by more than 70% of participants were informing prescribers and recommending alternative drugs, and alerting hospital staff about the presence of drug shortages using new communication tools. CONCLUSIONS: The relatively high reported rates of drug shortages in some hospitals should encourage health policymakers to address this serious public health problem. LIMITATIONS: The generazibility of the study's findings were limited by the small sample size, convenience sampling technique, self-reported data, and the fact that only pharmacists were invited to participate.

Abstract Background The quinazoline are an important class of medicinal compounds that possess a number of biological activities like anticancer, anticonvulsant and antioxidant etc. Results We evaluated the previously synthesized quinazoline derivatives 1–3 for their anticancer activities against three cancer cell lines (HepG2, MCF-7, and HCT-116). Among the tested compounds, quinazolines 1 and 3 were found to be more potent than the standard drug Vinblastine against HepG2 and MCF-7 cell lines. All the tested compounds had less antioxidant activity and did not exhibit any anticonvulsant activity. Also, molecular docking studies were performed to get an insight into the binding modes of the compounds with human cyclin-dependent kinase 2, butyrylcholinesterase enzyme, human gamma-aminobutyric acid receptor. These compounds showed better docking properties with the CDK2 as compared to the other two enzymes. Conclusions The overall study showed that thioxoquinazolines are suitable antitumor agents and they should be explored for other biological activities. Modification in the available lot of quinazoline and synthesis of its novel derivatives is essential to explore the potential of this class of compounds. The increase in the threat and with the emergence of drug resistance, it is important to explore and develop more efficacious drugs.

Dr. Kerr utilizes innovative counseling and therapy approaches to better understand the relationship of creativity to gender, privilege, and talent development. Given her interest in formative aspects of creative personality, Dr. Kerr has also done significant work with creative youth. This gender related aspect of creative personality and professional success leads into an area of research that Dr. Kerr is known for - in understanding creativity, gender and structural inequities. That said, Dr. Kerr is also sensitive to the fact that non-traditional approaches can be uncomfortable to traditional practitioners:. [Extracted from the article]

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